Collaborative Research: Computational Modeling, Simulation, and Validation for Tissue Transplantation

合作研究：组织移植的计算建模、模拟和验证

• 批准号: 1521266
• 负责人: Anastasios Matzavinos
• 金额: $ 16.9万
• 依托单位: Brown University
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2018-07-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1521266&HistoricalAwards=false
• 关键词: Collaborative; Research; Computational; Modeling; Simulation

A fundamental problem in tissue transplantation in reconstructive surgery is how to determine the size of tissue flap that can be transferred without the development of necrosis. An autologous tissue flap is a unit of tissue that is transferred from one site to another of the same patient while maintaining its own blood supply. Improved understanding of the anatomy of tissue blood supply combined with advances in instrumentation and surgical techniques has resulted in modern methods to transfer tissue based on single arteries and veins. Surgeons still rely on personal experience to make a qualitative assessment of the adequacy of blood supply when deciding the size of the flap. If unsuccessful, the blood supply will be inadequate for the amount of tissue transferred, and portions of the flap will not survive, wasting the whole surgery. This can result in significant postoperative complications, additional surgery, increased morbidity, and increased medical costs. It is therefore important to develop a practical tool to enable the most reliable flap design based on the adequacy of blood supply. In order to address this problem, this research project will develop robust mathematical models that allow estimating the diameter of the perforating artery and the level of oxygenation in a tissue given its size and shape. The problem in hand is complicated and warrants a truly patient-specific approach. Modeling and simulations are necessary in multiple scales, i.e., at the perforator level, at the intermediate vascular network level, and at the capillary level. Validating the model with existing patient data is a challenge. The mismatch of the size of the blood vessel between the donor site and the recipient site creates additional problems. Based on these issues, the objective of this research is to create sophisticated computational tools for successful flap transfer. To achieve this goal, the specific research objectives are 1) to create a mathematical model to predict blood flow and oxygen supply in surgical flaps, 2) to generate data-driven simulation in vascular architecture and image-based validation in perforator flaps, and 3) to design the flap geometry based on (a) simulation results of blood flow and oxygen transport and (b) data clustering analysis of flap parameters from previous surgeries. The research project is a fundamental synergy of mathematical modeling, medical science, and surgery. The adopted interdisciplinary approach combines the expertise of the mathematical modeling community with that of radiologists and plastic surgeons.

重建手术中组织移植的一个基本问题是如何确定在不发生坏死的情况下可以移植的组织瓣的大小。自体组织瓣是一种组织单位，可以从一个部位转移到同一患者的另一个部位，同时保持自身的血液供应。对组织血液供应的解剖学理解的提高，结合仪器和手术技术的进步，导致了基于单一动脉和静脉的组织转移的现代方法。外科医生在决定皮瓣大小时，仍然依靠个人经验对供血是否充足进行定性评估。如果不成功，血液供应将不足以满足移植组织的数量，部分皮瓣将无法存活，浪费了整个手术。这可能导致严重的术后并发症、额外的手术、发病率增加和医疗费用增加。因此，重要的是开发一种实用的工具，使最可靠的皮瓣设计基于充足的血液供应。为了解决这个问题，该研究项目将开发强大的数学模型，以估计穿孔动脉的直径和给定组织大小和形状的氧合水平。手头的问题很复杂，需要采取真正针对患者的方法。建模和模拟在多个尺度上是必要的，即在射孔器水平、中间血管网络水平和毛细血管水平。用现有的患者数据验证模型是一个挑战。供体部位和受体部位血管大小的不匹配产生了额外的问题。基于这些问题，本研究的目的是为成功的皮瓣转移创建复杂的计算工具。为了实现这一目标，具体的研究目标是：1)建立预测手术皮瓣血流和供氧的数学模型；2)生成血管结构的数据驱动模拟和穿支皮瓣的图像验证；3)基于(a)血流和氧运输的模拟结果和(b)以往手术皮瓣参数的数据聚类分析来设计皮瓣几何形状。该研究项目是数学建模、医学和外科学的基础协同作用。所采用的跨学科方法结合了数学建模社区的专业知识与放射科医生和整形外科医生的专业知识。